Explore Barriers Associated with Not Testing for HIV Among Men Who Have Sex With Men in Dodoma, City, Tanzania

Goal The goal of the project is to explore barriers associated with not testing for HIV among men who have sex with men (MSM) in Dodoma City, Tanzania. Objectives In order to achieve the goal of exploring barriers associated with not testing for HIV among MSM, I will plan and conduct the study, analyze the data, and prepare the final research report. Methods A qualitative descriptive study will be conducted in Dodoma City, Tanzania. A total of 10 MSM 19 years of age and above will be purposefully selected by 3 peer educators to be part of the study. I will also interview 5 service providers who provide HIV testing in Dodoma City. Participants will be asked open-ended questions in Swahili and the responses will be digital recorded. Transcripts will be translated and produced by me with the help of my husband. Results will be analyzed using a thematic and coding system. Results 10 participants were interviewed and majority of participants were young, high school graduates, single and worked mostly part-time while making very low income. There were seven themes and three subthemes generated from 34 codes. The seven themes were healthcare services(facilities), HIV knowledge &testing, barriers, provide education, resources or support, recommendations for health system acceptance of MSM and their need for healthcare, and recommendation on getting MSM to test for HIV. Personal barriers identified by MSM were fear of knowing, disrupt lifestyle, fear of disclosure; disrupt lifestyle and busy lifestyle. Barriers related to providers that were mentioned by MSM were provider stigma, lack of confidentiality, male providers= more attitude, poor provider attitude, busy lifestyle and delayed health care services. Conclusion In conclusion, MSM in Dodoma City and others around Tanzania need resources and support to help them seek testing for HIV. As many mentioned, they need trained providers who have learned the importance of confidentiality, understand who MSM are and can better support them when they go in for HIV testing without attitude and stigma. MSM also believe that their families also need to get educated so that they can better support them once they find out they are HIV positive and not stigmatize them

The Potential of Open Educational Resources (OERS) in Higher Education Curriculum and Course Materials Development

Open education resource (OER) is defined by UNESCO as “technology-enabled” open provision of educational resources for consultation, use and adaptation by a community of users for noncommercial purposes.’ These resources are freely available for use by educators and learners, without an accompanying need to pay royalties or license fees. With the explosion of knowledge and increasing sophistication of technology, higher education programmes need to be frequently reviewed and developed to keep pace with the needs of society and the learners. Taking into consideration the currently situation (increasing number of diverse learners) in higher education institutions, where the core activities are teaching, research, and consultancy; the curriculum development activity has become a more tedious work and require assistance from other existing source of materials and technology. OER has a big potential in assisting educators and curriculum developer to adapt and customize the resources to fit the institution needs and save more time in teaching, research and consultancy.Key words: Open Educational Resources (OER), Higher Education Institutions (HEI), Open Courseware, Information Communication Technologies (ICT), Curriculum, National Research and Education Network (NREN)

Targeted Subsidy for Malaria Control With Treated Nets Using a Discount Voucher System in Tanzania.

During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health services in the context of a social marketing programme and forming an IEC tool to demonstrate the group at most risk of severe malaria

Magnitude and factors associated with injection site infections among underfives in a district hospital, northern Tanzania

Injections are among the major procedures in health care facilities which need to be handled under sterile conditions. Unsafe injections have been found to cause deaths due to its associated complications.  The burden of injection site infections is unknown in Tanzania. This study was designed to determine the burden of injection site infections and factors associated to it among underfives in a district hospital, northern Tanzania. This cross-sectional hospital-based study was conducted at Huruma Hospital in Rombo District, northern Tanzania from November to December 2013. This study included children of less than five years attending reproductive child health clinic for the routine immunization. Demographic data and clinical information were collected using pre-tested self-administered questionnaires, with both closed and open ended questions. A total of 200 underfives attending clinics for vaccination were recruited. Majority (n=125, 62.5%) were males. Out of 200 underfives, 60 (30%) were infants. Injection site infections were observed in 18 (9%, 95% CI: 5-12.9) of children; of whom 13 (72.2%) were females. Factors associated with injection site infections were female sex (OR 5.03, 95% CI; 1.58-18.71, P=0.001), severe malnutrition (OR 90, 95% CI; 9.5-398, p<0.001) and HIV infection (OR 21.5, 95% CI; 4.27-114.19, p<0.001). In conclusion, injection site infection rate is relatively high in this hospital and was associated with female sex, malnutrition and positive HIV status.  Proper care and follow up should be instituted when injections are given to this high risk group of underfives. 

The Success of Health Insurance for Saudis Citizens: Hospital Privatization in Saudi Arabia

In order to fulfill the country's health sector developmental objectives, the Kingdom of Saudi Arabia has endeavored to reorganize and improve its health care systems. One area of health sector that has undergone profound change and significant progress is health insurance. Thus, this study aims to discuss the success of health insurance for citizens through Hospital Privatization in Saudi Arabia. The method of the study was based on a discussion of several studies about Hospital Privatization in Saudi Arabia and health insurance for Saudis citizens. This study found that to success and effectively apply the program of health insurance for Saudis citizens through hospital privatization in Saudi Arabia, it must overcome all obstacles that may face Saudi health system, such as organization of the health power, absence of capital and human asset obtaining coordination, quick increment in health uses, and the method for repayment, expanding competition, and endeavors at controlling costs, as well as, a deficiency of Saudi health experts, the health service's numerous parts, restricted money related assets, changing examples of malady, appeal coming about because of free administrations, a non-appearance of a national emergency administration arrangement, poor availability to some human services offices, absence of a national health data framework, and the underutilization of the capability of electronic health systems. Moreover, the study concluded that the country that wants to privatize its health system, it must take effective strategy producers to direct the part that private medical insurance will play in their health frameworks and direct the segment properly with the goal that it serves public objectives of widespread scope and value. The current form of the insurers may not be able to insurance all citizens, thus, this study recommended that the Saudi government must let the foreign insurance companies to enter into the Saudi health insurance market to enable citizens to get high-quality health service

The silent burden of anaemia in Tanzania children:a community-based study

Objective was to document the prevalence, age-distribution, and risk factors for anaemia in Tanzanian children less than 5 years old,thereby assisting in the development of effective strategies for controlling anaemia.\ud \ud Cluster sampling was used to identify 2417 households at random from four contiguous districts in south-eastern\ud United Republic of Tanzania in mid-1999. Data on various social and medical parameters were collected and analysed.\ud \ud Blood haemoglobin concentrations (Hb) were available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to 18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of all three levels was in children aged 6–11 months, of whom 10% (22/226) had an Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged 1–5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5 g/dl). Anaemia was usually asymptomatic and when symptoms arose they were nonspecific and rarely identified as a serious illness by the care provider. A recent history of treatment with antimalarials and iron\ud was rare. Compliance with vaccinations delivered through the Expanded Programme of Immunization (EPI) was 82% and was notassociated with risk of anaemia.\ud \ud Anaemia is extremely common in south-eastern United Republic of Tanzania, even in very young infants. Further implementation of the Integrated Management of Childhood Illness algorithm should improve the case management of anaemia. However, the asymptomatic nature of most episodes of anaemia highlights the need for preventive strategies. The EPI has good coverage of the target population and it may be an appropriate channel for delivering tools for controlling anaemia and malaria

Cluster-randomized study of intermittent preventive treatment for malaria in infants (IPTi) in southern Tanzania: evaluation of impact on survival.

BACKGROUND\ud \ud Intermittent Preventive Treatment for malaria control in infants (IPTi) consists of the administration of a treatment dose of an anti-malarial drug, usually sulphadoxine-pyrimethamine, at scheduled intervals, regardless of the presence of Plasmodium falciparum infection. A pooled analysis of individually randomized trials reported that IPTi reduced clinical episodes by 30%. This study evaluated the effect of IPTi on child survival in the context of a five-district implementation project in southern Tanzania. [Trial registration: clinical trials.gov NCT00152204].\ud \ud METHODS\ud \ud After baseline household and health facility surveys in 2004, five districts comprising 24 divisions were randomly assigned either to receive IPTi (n = 12) or not (n = 12). Implementation started in March 2005, led by routine health services with support from the research team. In 2007, a large household survey was undertaken to assess the impact of IPTi on survival in infants aged two-11 months through birth history interviews with all women aged 13-49 years. The analysis is based on an "intention-to-treat" ecological design, with survival outcomes analysed according to the cluster in which the mothers lived.\ud \ud RESULTS\ud \ud Survival in infants aged two-11 months was comparable in IPTi and comparison areas at baseline. In intervention areas in 2007, 48% of children aged 12-23 months had documented evidence of receiving three doses of IPTi, compared to 2% in comparison areas (P < 0.0001). Over the three years of the study there was a marked improvement in survival in both groups. Between 2001-4 and 2005-7, mortality rates in two-11 month olds fell from 34.1 to 23.6 per 1,000 person-years in intervention areas and from 32.3 to 20.7 in comparison areas. In 2007, divisions implementing IPTi had a 14% (95% CI -12%, 49%) higher mortality rate in two-11 month olds in comparison with non-implementing divisions (P = 0.31).\ud \ud CONCLUSION\ud \ud The lack of evidence of an effect of IPTi on survival could be a false negative result due to a lack of power or imbalance of unmeasured confounders. Alternatively, there could be no mortality impact of IPTi due to low coverage, late administration, drug resistance, decreased malaria transmission or improvements in vector control and case management. This study raises important questions for programme evaluation design

Prevalence and predictors of intestinal schistosomiasis among the adult population, and water and sanitation conditions - A community-based cross-section study at Muleba District, Tanzania

INTRODUCTION: Intestinal schistosomiasis is one of the serious public health problems in all age groups and can lead to considerable morbidity and mortality, especially in communities with an inadequate supply of safe water and sanitation services. This study was conducted to establish the current burden of intestinal schistosomiasis among adults in the Muleba District and assess water and sanitation conditions that might influence the transmission of intestinal schistosomiasis.METHODS: A community-based cross-sectional study was conducted between July and August 2020. A total of 328 stool samples were collected and processed using formal-ether concentration and Kato-Katz methods. Water and sanitation data were collected using a questionnaire interview conducted among participants. Participants were randomly selected from four villages. Data were analyzed using Statistical Package for the Social Sciences software version 23.RESULTS: Thirty-six participants (11%) were infected with Schistosoma mansoni. The prevalence was higher among households using water from improved sources, houses without sanitation facilities, and participants who do not use sanitation facilities. We found a significantly increased risk of S. mansoni infection among participants in households without toilet facilities than those with ventilated improved pit latrine (OR =4.10, p = 0.001).CONCLUSION: The prevalence of intestinal schistosomiasis infection among the adult population in Muleba indicates a moderate risk of transmission. The type of toilet facility is a significant factor in the perpetuation of S. mansoni transmission

Critical Discourse Analysis (CDA) of Academic Texts: A Potential Strategy in Addressing Challenges of Cross-border Provision of Higher Education in Sub-Saharan Africa

Using discourse from written texts representing information about New Information Communication Technologies (NICTs) in distance education (DE) in Sub-Sahara Africa (SSA) the author shows how texts/discourse may be used to marginalize people who have systematically been made powerless. Awareness of Critical Discourse Analysis (CDA) and the ability to use it as an emancipatory tool are represented as techniques that may be employed to uncover marginalization and exploitation. Texts, including academic texts, are represented as avenues for colonizing minds as explored by CDA scholars such as Fairclough (1995), Van Djik (1993) and Kress (1989). Such colonization translates into other forms of colonization, which are the root causes of exploitation, marginalization, and subordination. The author provides practical examples of written text extracts, analyses the extracts using CDA and critically interprets the texts to show how CDA may be employed as a means to decolonize minds of peoples in Sub-Saharan Africa. CDA is represented to have the potency to open up for critical conceptualization of the real world as presented in written texts which influence how people live and act. In the context of this paper discourse is considered a social practice that influences other forms of social practices. Taking from Van Djik’s (1993) position, the stated influence is grounded on discourse as a symbolic practice that embodies the social environment that shapes “public mind”, “social cognition” ( p. 257) and the social actions that ensue from such minds and cognition. Furthermore, the author bases her prepositions on Fairclough’s (2004) perception of discourse as a tool that can be used to control the selection of certain structural possibilities and the exclusion of others and the retention of the selections in particular areas of social life

Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa:A Scoping Review

Introduction: Alcohol use disorder (AUD) is among the leading cause of morbidity and mortality in sub-Saharan Africa. Despite this, AUD is often not detected in health care settings, which contributes to a wide treatment gap. Integrating services for mental, neurological, and substance use disorders in general health care settings is among the recommended strategies to narrow this treatment gap. This scoping review aimed to map the available evidence on integration of AUD interventions in general health care settings in sub-Saharan Africa.Methods: We searched four databases (PubMed, PsycINFO, CINAHL, and Africa Wide Information) for publications up to December 2020. The search strategy focused on terms for alcohol use, alcohol interventions, and sub-Saharan African countries. Studies that reported AUD interventions in general health care settings in sub-Saharan Africa were eligible for inclusion. Over 3,817 potentially eligible articles were identified. After the removal of duplicates and screening of abstracts, 56 articles were included for full article review. Of these, 24 papers reporting on 22 studies were eligible and included in a narrative review.Results: Of the 24 eligible articles, 19 (80%) described AUD interventions that were being delivered in general health care settings, 3 (12%) described plans or programs for integrating AUD interventions at different levels of care, including in health facilities, and 2 (8%) studies reported on AUD interventions integrated into general health care settings.Conclusions: This review shows that there is limited evidence on the integration of AUD interventions in health care settings in sub-Saharan Africa. There is an urgent need for studies that report systematically on the development, adaptation, implementation, and evaluation of integrated AUD interventions in health care settings in sub-Saharan Africa